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The agencies endangered the public by failing to investigate an outbreak of hookworm

Lowndes County residents gather at the 1st Baptist Church of Hayneville, Ala. to discuss the need to install costly septic systems, or face jail time, April 30, 2002.

Dave Martin / AP Photo

We hope that the Department of Health and Human Services will exercise its power under federal civil rights law to resolve the discriminatory conduct that has long deprived African American residents in the Black Belt from functional wastewater systems and adequate protections of their health.

Anna Sewell

Attorney, Earthjustice

September 28, 2018

Washington, D.C. —

The Alabama Department of Public Health and the Lowndes County Health Department are facing a federal civil rights complaint that alleges both agencies discriminated against African American residents of Lowndes County, Ala.

The complaint, filed today, with the U.S. Department of Health and Human Services alleges the state’s health department and the county’s health department administered their sewage disposal program and their infectious diseases program in ways that have a disparate impact based on race.

The county dismissed a credible outbreak of hookworm and failed to investigate or abate the sanitation conditions that produced the outbreak, despite prior knowledge of discriminatory acts.

The failure followed a 2017 peer-reviewed published study from Baylor University that found that 34.5 percent of Lowndes County residents tested positive for having low levels of hookworm. The study relied on the most sensitive and up-to-date methods to detect parasitic worms.

Both the state’s health department and the county’s health department have a legal obligation to investigate the causes, modes or propagation and means of prevention of diseases.

But, instead of investigating and attempting to abate the problems, the state health department posted a notice on its website on April 9, 2018, saying that no presence of hookworm was found in Lowndes County. The notice discounted the validity of the study, mischaracterized the evidence and endangered the community. The agency’s “rejection of the study’s findings misled the public by incorrectly assuring residents there is no evidence of a hookworm outbreak when in fact there is very strong evidence that a hookworm outbreak is currently occurring in Lowndes County,” the complaint states.

In addition, to misinforming the public, the state has a track record of prosecuting only black county residents because of the sewage problems they face, in essence punishing them for lacking access to wastewater services, while ignoring its responsibility to prevent diseases and address sanitation problems.

Alabama state law makes it a criminal misdemeanor to “build, maintain or use an insanitary sewage collection,” meaning any system that is not a permitted septic tank. In addition to the potential for jail time, a violation of the insanitary conditions law is punishable by a fine of $500. From 1999 to 2002, the state issued arrest warrants for at least 10 Lowndes County residents for violating the insanitary sewage collection law, all of whom were African American.

Black residents in the county have less access to legally permitted wastewater treatment systems.

Lowndes County, a region between Selma and Montgomery, is referred to as Alabama’s Black Belt because of its black, clayey, shrink-swell soil that was considered ideal for growing cotton. The county is 73 percent black and the density of the mostly black population is in large part due to the prevalence of plantations there before the Civil War and the dependence on enslaved black labor to grow and produce cotton there. While the soil worked well for growing cotton, the clay-like nature of the soil makes it virtually impermeable and heavy enough to crack conventional sewer systems.

Many homeowners rely on straight PVC pipes that carry sewage from mobile homes to trenches that often overflow during heavy rains, bringing the waste into people’s yards where children play.

Catherine Flowers, founder of the Alabama Center for Rural Enterprise, which initiated the complaint, said the sewage problems in Lowndes are another form of racial oppression for black residents.

“It is a terrible injustice that a region that has borne a tremendous burden of systemic racial oppression from the times of cotton plantations to the civil rights era when black people were locked out of voting has to live with the degradation of unsanitary or nonexistent sewer systems,” Flowers said. “We are hoping this complaint helps make a difference in the lives of African Americans who deserve the same rights to water and decent health as everyone else.”

Under Title VI of the Civil Rights Act, it is illegal for an agency to receive federal money and discriminate on the basis of race, color, or national origin. Discrimination need not be intentional. The term under the Civil Rights Act refers to any decision that has an unjustified unequal impact.

Poverty is divided starkly along racial lines in Lowndes County. While only four percent of white residents live below the poverty line in Lowndes, 37 percent of African Americans live in poverty. The median income for African Americans is $21,686 while the median income for whites is more than double that amount at $52,604.

Black residents are often unable to pay for a suitable septic system, which could cost as much as $30,000 — far in excess of their annual income and often more costly than the value of their homes. The median household value for a mobile home in Lowndes in $23,900.

The issue of inadequate sewer service drew international attention from the United Nations’ Human Rights Council twice in the last decade.

In December 2017, the UN Special Rapporteur Phillip Alston noted the “cesspools of sewage” and “broken or non-existent septic systems” plaguing African American communities in the Lowndes County area and contrasted that condition with well-maintained buildings and sewer systems in cities where most white people lived.

He also noted that state health officials had no knowledge of how many people were living with sewage problems in the county despite the serious health risks and had no plan to address these matters.

The complaint calls on both the state and the county to address the discrimination by retracting the public notice that there is no evidence of hookworm in Lowndes County; informing residents of Lowndes and neighboring counties about the 19 confirmed cases of hookworm and educating the public about risks of infection and available treatment.

In addition, the Alabama Center for Rural Enterprise is seeking an independent investigation of the failing and inadequate wastewater system issues without threat of fines or arrests along with the implementation of a program that provides adequate onsite wastewater treatment systems to low-income homeowners who cannot afford them both in Lowndes County and other black belt counties.

“We hope that the Department of Health and Human Services will exercise its power under federal civil rights law to resolve the discriminatory conduct that has long deprived African American residents in the Black Belt from functional wastewater systems and adequate protections of their health,” said Anna Sewell, attorney at Earthjustice.